How the NDIS helps young people living in aged care

By Rachel Lane

24 February 2018 — 11:01pm

By 2019, more than 460,000 people will access the National Disability Insurance Scheme (NDIS). As part of the rollout, over 6000 young people who currently live in aged care, and the more than 2000 who enter aged care each year, may find themselves “dual participants” – that is, living in aged care facilities and also able to access NDIS funding.

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NDIS funding can be used to pay some, but not all, of the costs of aged care accommodation and care. It can also be used to access additional support services. The young person can choose to have these services provided by the aged care provider (if the aged care provider is also an approved NDIS provider) or by an external provider. A young person entering aged care is still required to undergo an ACAT assessment.

To be eligible for NDIS funding the person will need to be assessed by the National Disability Insurance Agency (NDIA). They will need to:

have a permanent disability that significantly affects their ability to take part in everyday activities

be less than 65 years old when they apply for the NDIS

live in Australia in an NDIS area

be an Australian citizen or hold a permanent visa or ‘protected special category’ visa.

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There are 6000 young people with disabilities living in aged care accommodation.

As part of the assessment they will need to provide evidence of their disability, outline the goals they wish to achieve as well as provide a copy of their aged care agreement and a statement of the fees and charges they are paying. Understanding that NDIS funding is a goals based system and not simply a care funding scheme is really important to ensuring you are prepared for your meeting.

The table below sets out which aged care costs can and can’t be funded by NDIS.

Case Study

Ben, 28, has a brain injury as a result of a trail bike accident, and has been living in residential aged care since 2017.

Ben has paid $200,000 towards his RAD of $550,000. This leaves him with $150,000 in investments and $10,000 of personal assets.

Let’s look at Ben’s cost of aged care with and without the NDIS.

In addition to the $60.08 a day ($21,929 a year) funding provided to assist Ben in meeting his aged care costs, the NDIS provides $62,000 a year to support Ben to remain active in the community and work towards leaving aged care. In addition, $1395 is provided to cover the cost of a financial intermediary to manage the payments.

While $62,000 may seem like a lot of money, when you see alarming statistics like that 82 per cent of young people living in aged care rarely or never visit family or friends, you can understand why it is needed.

If you or a loved one find yourselves in this situation know that you are not on your own, there are wonderful organisations, such as the Summer Foundation, who work with young people in aged care — assisting them to access the care and support they need, and helping them to find alternatives to aged care.

As the NDIS is rolled out, young people living in aged care (or their representatives) will be contacted by the NDIS to discuss their eligibility and access to services. People can contact the NDIS to request access up to 6 months prior to the NDIS roll-out in their region.

Rachel Lane is the principal of Aged Care Gurus and has co-authored a number of books including Aged Care, Who Cares? This is a new fortnightly column on retirement living. Email: asktheguru@agedcaregurus.com.au